Covid-19 Pandemic Strategy for Treatment of Acute Uncomplicated Appendicitis with Antibiotics- Risk Categorization and Shared Decision-Making

Yap, Te‐Lu; Li, Fay XZ; Lee, It Ning; Chen, Yong; Choo, Candy S C; Sim, Siam Wee; Rai, Rambha; Ong, Lin Yin

doi:10.1016/j.jpedsurg.2023.02.052

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…The novel application of NOM during the initial pandemic assault has shown that NOM can be an effective management strategy [11,94,95]. When proper standards and strict patient selection criteria for applying NOM are set, informed decision making by parents can be made with acceptable cost effectiveness [9,35,42].…”

Section: Recurrent Appendicitis After Non-operative Managementmentioning

confidence: 99%

Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review

et al. 2023

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Global pandemics cause health system disruptions. The inadvertent disruption in surgical emergency care during the Coronavirus Disease 2019 (COVID-19) pandemic has been the topic of several published studies. Our aim was to summarize the reasons that led to the delayed diagnosis of pediatric appendicitis during the COVID-19 era. This systematic literature search evaluated studies containing pediatric appendicitis patient data regarding outcomes, times to hospital admission or times from symptom onset to emergency department visit. Studies elucidating reasons for delays in the management of pediatric appendicitis were also reviewed. Ultimately, 42 studies were included. Several reasons for delayed diagnosis are analyzed such as changes to public health measures, fear of exposure to COVID-19, increased use of telemedicine, COVID-19 infection with concurrent acute appendicitis, recurrence of appendicitis after non-operative management and increased time to intraoperative diagnosis. Time to hospital admission in conjunction with patient outcomes was extracted and analyzed as an indicative measure of delayed management. Delayed diagnosis of acute appendicitis has been documented in many studies with various effects on outcomes. Suspicion of pediatric acute appendicitis must always lead to prompt medical examination, regardless of pandemic status. Telemedicine can be valuable if properly applied. Data from this era can guide future health system policies.

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